Question the study is trying to answer: do we _really_ have to LP these people if they just have the characteristic ocular findings?

Study design: chart review of 116 patients with VKH

Results: only 10 patients were identified who had had LP; all 10 were Hispanic. 9 had had at least a headache, with varying other meningeal or auditory signs. 8 had abnormal CSF (6 with pleocytosis, 1 with “few WBC”, and 1″abnormal”, not specified further).

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Basically, the authors don’t love the spinal tap based on it being somewhat nonspecific and claiming the risks outweigh the benefits since the diagnosis can be essentially confirmed with ocular testing. I think this paper got cited a bunch elsewhere because I kept reading a statistic that “80%” had CSF pleocytosis, but 8/10 is not so very impressive, especially since it was such a small fraction of their VKH cohort.